Diagnostic Medical Sonographers

Job opportunities should be favorable, as sonography becomes
an increasingly attractive alternative to radiologic procedures.

About 6 out of 10 sonographers were employed by hospitals,
and most of the rest worked in offices of physicians or in medical
and diagnostic laboratories, including diagnostic imaging centers.

Sonographers may train in hospitals, vocational-technical
institutions, colleges and universities, and the Armed Forces.

Nature of the Work

Diagnostic imaging embraces several procedures that aid in diagnosing
ailments. Besides the familiar x-ray, another common diagnostic
imaging method is magnetic resonance imaging, which uses giant
magnets that create radio waves, rather than radiation, to form
an image. Not all imaging technologies use ionizing radiation
or radio waves, however. Sonography, or ultrasonography, is the
use of sound waves to generate an image for the assessment and
diagnosis of various medical conditions. Sonography usually is
associated with obstetrics and the use of ultrasound imaging during
pregnancy, but this technology has many other applications in
the diagnosis and treatment of medical conditions.

Diagnostic medical sonographers, also known as ultrasonographers,
use special equipment to direct nonionizing, high frequency sound
waves into areas of the patient’s body. Sonographers operate the
equipment, which collects reflected echoes and forms an image
that may be videotaped, transmitted, or photographed for interpretation
and diagnosis by a physician.

Sonographers begin by explaining the procedure to the patient
and recording any medical history that may be relevant to the
condition being viewed. They then select appropriate equipment
settings and direct the patient to move into positions that will
provide the best view. To perform the exam, sonographers use a
transducer, which transmits sound waves in a cone- or rectangle-shaped
beam. Although techniques vary with the area being examined, sonographers
usually spread a special gel on the skin to aid the transmission
of sound waves.

Viewing the screen during the scan, sonographers look for subtle
visual cues that contrast healthy areas with unhealthy ones. They
decide whether the images are satisfactory for diagnostic purposes
and select which ones to show to the physician. Sonographers take
measurements, calculate values, and analyze the results in preliminary
reports for the physicians.

Diagnostic medical sonographers may specialize in obstetric and
gynecologic sonography (the female reproductive system), abdominal
sonography (the liver, kidneys, gallbladder, spleen, and pancreas),
neurosonography (the brain), or breast sonography. In addition,
sonographers may specialize in vascular technology or echocardiography.

Obstetric and gynecologic sonographers specialize in the
study of the female reproductive system. Included in the discipline
is one of the more well-known uses of sonography: examining the
fetus of a pregnant woman to track the baby’s growth and health.

Abdominal sonographers inspect a patient’s abdominal cavity
to help diagnose and treat conditions primarily involving the
gallbladder, bile ducts, kidneys, liver, pancreas, and spleen.
Abdominal sonographers also are able to scan parts of the chest,
although studies of the heart using sonography usually are done
by echocardiographers.

Neurosonographers focus on the nervous system, including
the brain. In neonatal care, neurosonographers study and diagnose
neurological and nervous system disorders in premature infants.
They also may scan blood vessels to check for abnormalities indicating
a stroke in infants diagnosed with sickle-cell anemia. Like other
sonographers, neurosonographers operate transducers to perform
the sonogram, but use frequencies and beam shapes different from
those used by obstetric and abdominal sonographers.

Breast sonographers use sonography to study the disease
in breasts. Sonography aids mammography in the detection of breast
cancer. Breast sonography can also track tumors, blood supply
conditions, and assist in the accurate biopsy of breast tissue.
Breast sonographers use high-frequency transducers, made exclusively
to study breast tissue.

In addition to working directly with patients, diagnostic medical
sonographers keep patient records and adjust and maintain equipment.
They also may prepare work schedules, evaluate equipment purchases,
or manage a sonography or diagnostic imaging department.

Working Conditions

Most full-time sonographers work about 40 hours a week. Hospital-based
sonographers may have evening and weekend hours and times when
they are on call and must be ready to report to work on short
notice.

Sonographers typically work in healthcare facilities that are
clean and well lighted. Some travel to patients in large vans
equipped with sophisticated diagnostic equipment. A growing number
of sonographers work as contract employees and may perform tests
at a number of different hospitals. Sonographers are on their
feet for long periods and may have to lift or turn disabled patients.
They work at diagnostic imaging machines, but also may perform
some procedures at patients’ bedsides.

Training, Other Qualifications, and Advancement

There are several avenues for entry into the field of diagnostic
medical sonography. Sonographers may train in hospitals, vocational-technical
institutions, colleges and universities, and the Armed Forces.
Some training programs prefer applicants with a background in
science or experience in other healthcare professions, but also
will consider high school graduates with courses in mathematics
and science, as well as applicants with liberal arts backgrounds.

Colleges and universities offer formal training in both 2- and
4-year programs, culminating in an associate or a bachelor’s degree.
Two-year programs are most prevalent. Course work includes classes
in anatomy, physiology, instrumentation, basic physics, patient
care, and medical ethics. The Commission on Accreditation for
Allied Health Education Programs accredits most formal training
programs—132 programs in 2005.

Some healthcare workers, such as obstetric nurses and radiologic
technologists, increase their marketability by seeking training
in fields such as sonography. This usually requires completion
of an additional 1-year program that may result in a certificate.
In addition, sonographers specializing in one particular discipline
often seek competency in others; for example, obstetric sonographers
might seek training in abdominal sonography to broaden their opportunities.

Although no State requires licensure in diagnostic medical sonography,
organizations such as the American Registry for Diagnostic Medical
Sonography (ARDMS) certify the competency of sonographers through
registration. Because registration provides an independent, objective
measure of an individual’s professional standing, many employers
prefer to hire registered sonographers. Registration with ARDMS
requires passing a general physical principles and instrumentation
examination, in addition to passing an exam in a specialty such
as obstetric and gynecologic sonography, abdominal sonography,
or neurosonography. To keep their registration current, sonographers
must complete continuing education to stay abreast of technological
advances related to the occupation.

Sonographers need good communication and interpersonal skills
because they must be able to explain technical procedures and
results to their patients, some of whom may be nervous about the
exam or the problems it may reveal. Sonographers also should have
a background in mathematics and science

Employment

Diagnostic medical sonographers held about 42,000 jobs in 2004.
About 6 out of 10 sonographer jobs were in hospitals—public and
private. Most of the rest were in offices of physicians or in
medical and diagnostic laboratories, including diagnostic imaging
centers.

Job Outlook

Employment of diagnostic medical sonographers is expected to
grow much faster than the average for all occupations through
2014 as the population grows and ages, increasing the demand for
diagnostic imaging and therapeutic technology. In addition to
job openings from growth, some job openings will arise from the
need to replace sonographers who leave the occupation permanently.

Opportunities should be favorable because sonography is becoming
an increasingly attractive alternative to radiologic procedures,
as patients seek safer treatment methods. Unlike most diagnostic
imaging methods, sonography does not involve radiation, so harmful
side effects and complications from repeated use are rarer for
both the patient and the sonographer. Sonographic technology is
expected to evolve rapidly and to spawn many new sonography procedures,
such as 3D- and 4D-sonography for use in obstetric and ophthalmologic
diagnosis. However, high costs may limit the rate at which some
promising new technologies are adopted.

Hospitals will remain the principal employer of diagnostic medical
sonographers. However, employment is expected to grow more rapidly
in offices of physicians and in medical and diagnostic laboratories,
including diagnostic imaging centers. Healthcare facilities such
as these are expected to grow very rapidly through 2014 because
of the strong shift toward outpatient care, encouraged by third-party
payers and made possible by technological advances that permit
more procedures to be performed outside the hospital.

Earnings

Median annual earnings of diagnostic medical sonographers were
$52,490 in May 2004. The middle 50 percent earned between $44,720
and $61,360 a year. The lowest 10 percent earned less than $37,800,
and the highest 10 percent earned more than $72,230. Median annual
earnings of diagnostic medical sonographers in May 2004 were $53,790
in offices of physicians and $51,860 in general medical and surgical
hospitals.